贝伐单抗在卵巢癌新辅助化疗中的疗效与安全性分析：一项系统评价与荟萃分析
Efficacy and safety analyses of bevacizumab in neoadjuvant chemotherapy for ovarian cancer: a systematic review and meta-analysis.
作者信息
Wang Yijun, Wang Yicong, Wang Lei, Yuan He, Yu Yongai, Liu Daju
机构信息
Department of Obstetrics and Gynecology, Dalian Municipal Central Hospital, Dalian, China.
出版信息
Front Pharmacol. 2025 May 30;16:1566604. doi: 10.3389/fphar.2025.1566604. eCollection 2025.
OBJECTIVE
To assess the efficacy and safety of bevacizumab in neoadjuvant chemotherapy for ovarian cancer through systematic evaluation and meta-analysis.
METHODS
Online databases, such as PubMed, Embase, and the Cochrane Library, were searched for relevant articles on the treatment of ovarian cancer patients with interval debulking surgery after neoadjuvant chemotherapy in combination with the bevacizumab regimen using the keywords "Ovarian Neoplasms," "Bevacizumab," "Monoclonal antibodies against vascular endothelial growth factor," "Avastin," and "Neoadjuvant Therapy." A meta-analysis of the screened literature, which included randomized controlled trials and cohort studies, was then performed using Stata 15.0 software.
RESULTS
The meta-analysis included five eligible papers. The test group consisted of 160 patients who received paclitaxel + carboplatin + bevacizumab prior chemotherapy (TCB), whereas the control group consisted 211 patients who received paclitaxel + carboplatin (TC). The results indicate that there was no significant difference between the two groups in terms of the rate of optimal cytoreduction (RR = 1.124, 95% CI: 0.947-1.335, P = 0.182; Heterogeneity: = 40.3%, p = 0.152) and progression-free survival (PFS) (HR = 0.74, 95% CI: 0.48-1.14, p = 0.173; Heterogeneity: = 86%, p = 0.007). Neoadjuvant chemotherapy with bevacizumab did not increase the incidence of adverse events in chemotherapy (RR = 0.88, 95% CI: 0.713-1.088, p = 0.238; Heterogeneity: = 49.5%, p = 0.095). The rate of postoperative complications in the TCB group was comparable to that in the TC group (RR = 0.955, 95% CI:0.672-1.359, p = 0.799; Heterogeneity: = 6.8%, p = 0.368).
CONCLUSION
The use of bevacizumab in neoadjuvant chemotherapy for advanced ovarian cancer was safe and feasible but did not significantly improve the satisfactory tumor reduction rate of interval debulking surgery and had no effect on the prolongation of postoperative PFS. Hence, the use of bevacizumab in preemptive chemotherapy for ovarian cancer should be carefully considered.
SYSTEMATIC REVIEW REGISTRATION
https://inplasy.com/inplasy-2024-12-0065/, INPLASY2024120065.
目的
通过系统评价和荟萃分析评估贝伐单抗在卵巢癌新辅助化疗中的疗效和安全性。
方法
在PubMed、Embase和Cochrane图书馆等在线数据库中，使用关键词“卵巢肿瘤”“贝伐单抗”“抗血管内皮生长因子单克隆抗体”“阿瓦斯汀”和“新辅助治疗”搜索有关新辅助化疗联合贝伐单抗方案后接受间歇性肿瘤细胞减灭术的卵巢癌患者治疗的相关文章。然后使用Stata 15.0软件对筛选出的文献进行荟萃分析，其中包括随机对照试验和队列研究。
结果
荟萃分析纳入了五篇符合条件的论文。试验组由160例在化疗前接受紫杉醇+卡铂+贝伐单抗（TCB）的患者组成，而对照组由211例接受紫杉醇+卡铂（TC）的患者组成。结果表明，两组在最佳肿瘤细胞减灭率（RR = 1.124，95%CI：0.947 - 1.335，P = 0.182；异质性： = 40.3%，p = 0.152）和无进展生存期（PFS）（HR = 0.74，95%CI：0.48 - 1.14，p = 0.173；异质性： = 86%，p = 0.007）方面无显著差异。贝伐单抗新辅助化疗未增加化疗中不良事件的发生率（RR = 0.88，95%CI：0.713 - 1.088，p = 0.238；异质性： = 49.5%，p = 0.095）。TCB组术后并发症发生率与TC组相当（RR = 0.955，95%CI：0.672 - 1.359，p = 0.799；异质性： = 6.8%，p = 0.368）。
结论
贝伐单抗用于晚期卵巢癌新辅助化疗安全可行，但未显著提高间歇性肿瘤细胞减灭术令人满意肿瘤缩小率，且对延长术后PFS无作用。因此，应谨慎考虑将贝伐单抗用于卵巢癌的预防性化疗。
系统评价注册
https://inplasy.com/inplasy - 2024 - 12 - 0065/，INPLASY2024120065。
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